Chest computed tomography findings. The images before the administration of chemotherapy showed paraseptal emphysema but not GGOs or reticular shadows (A, B). After the third cycle of chemotherapy, subpleural and basal predominant reticular shadow, cystic structures, and peripheral traction bronchiectasis with volume loss were observed in the left lower lobe (C), and peribronchovascular consolidation with GGO was observed in the right lower lobe (D). The images at the onset of acute exacerbation showed additional bilateral GGO and consolidation with progressive traction bronchiectasis and volume loss of bilateral lower lobes (E, F). Methylprednisolone pulse followed by high-dose prednisolone and tacrolimus improved the GGO and consolidation (G, H).